HIV/AIDS in South Africa

South Africa has given the world an inspiring example of a peaceful
transition from the apartheid regime to a democracy. These achievements
are endangered through the growing AIDS pandemic and all its social and political consequences.

On 10 November 2009, Health Minister Aaron Motsoaledi unveiled what
he himself described as shocking figures showing a huge Aids-related
leap in South Africa’s death rate.

“In 11 years [from 1997 to 2008], the rate
of death has doubled in South Africa. That is obviously something that
cannot but worry a person,” he told a media briefing at Parliament.

Motsoaledi pinned the blame for the current scale of the pandemic
squarely on the denialist health policies pursued by former president
Thabo Mbeki’s government.

The Health Minister called for urgent implementation of a campaign to
create a “massive change in behaviour and attitude” towards HIV/Aids among citizens.

He said in 2007, the total number of deaths – from all causes –
registered in South Africa was 573 408; in 2008, this figure had leapt
to 756 062.

“If this trend goes on – I don’t have 2009
figures, [but] we might easily have reached 900 000 [deaths] by now –
I’m worried because… in 1997 the death rate was about 300 000.

“If in 2008 it’s 756 062 it means the rate of deaths increased by more than 100% within… 11 years,” he said.

Researchers attribute the sharp rise in the total number of registered deaths to the HIV/Aids
pandemic. They believe such a change in the death rate to be a better
indicator of the spread of the pandemic than absolute HIV/Aids figures, because the majority of deaths owing to HIV/Aids are misclassified.

Motsoaledi said the worst-effected provinces were KwaZulu-Natal (where the HIV/Aids
prevalence rate in 2008, measured among antenatal women, was 38,7%),
followed by Mpumalanga (35,5%) and Free State (32,9%).

The least-affected provinces were the Northern and Western Cape (16,2% and 16,1% respectively).

Asked to what extent “denials” by the previous administration and an “abdication of the fight against HIV/Aids” had led to the current scale of the pandemic, Motsoaledi said the fact that it had was obvious.

“On [the figures], it’s shocking. As to
whether it has been affected by what we did in the past ten years, to me
that’s obvious… I don’t think we’d have been here if we’d approached
the problem in a different way.

Motsoaledi cited the current relatively low incidence of HIV/Aids in the Western Cape as an example of how providing antiretrovirals to HIV positive people could reduce incidence of the disease.

“I have shown you figures of how the
Western Cape reversed [the trend]. Infant mortality in the province
dropped… within three years [between 2003 and 2006] because of extensive
dual [antiretroviral] therapy. So you can reverse it… if you develop
good strategies.”

The majority of the HIV/Aids deaths were among young people, particularly young women.

According to figures published in The Lancet medical journal, South Africa was carrying a huge part of the global HIV/Aids burden.

“We are 0,7% of the world population, but we are carrying 17% of its HIV/Aids burden… When you take the global average of HIV/Aids, the country is 23-times the global average,” he said.

Other figures presented by Motsoaledi include a massive increase in
the number of people dying from tuberculosis, the main cause of death of
HIV-infected people.

A total of 22 071 people died of TB in 1997; in 2005, 73 903 people died of this disease, a 334,8% increase, and seven-times the global average.

Further, a total of 57% of children who died during 2007, died as a result of HIV/Aids.

Life expectancy in South Africa was an estimated 13 years below what it would be without HIV/Aids – in 2006, 56 years for women, and 51 years for men.

Motsoaledi said strategic leadership was needed in the campaign to check the pandemic.